J Korean Surg Soc.  2000 Aug;59(2):229-236.

Laparoscopy in the Acute Abdomen

• Choi IS
• Jung KH
• Kim SH

Abstract

PURPOSE: We assessed the feasibility and efficacy of a laparoscopic approach in surgically managing various conditions of the acute abdomen. METHODS: This report presents preliminary data from our ongoing prospective study. Sixty patients underwent a diagnostic or a therapeutic laparoscopy for acute or subacute abdominal conditions between July 1997 and September 1998. RESULTS: Conditions were classified into trauma (n=8), peritonitis (n=41), and obstruction (n=11). Trauma included 5 blunt (2 small bowel perforations, 1 spleen rupture, 2 mesenteric ruptures) and 3 stab injuries. Peritonitis included 23 duodenal ulcer perforations, 10 acute cholecytitis/empyema, 3 colon perforations, 1 tuberculous peritonitis, 1 ectopic pregnancy, 1 ruptured corpus luteum, 1 appendicitis, and 1 ruptured liver abscess. Obstruction included 5 intussusceptions (4 Children, 1 adult), 2 intestinal adhesions; and 4 congenital hypertropic pyloric stenoses. Among the 54 cases of therapeutic laparoscopy, 9 cases were converted during the procedure (conversion rate: 16.7%). There were 2 intraoperative (bowel perforation) and 4 postoperative (1 subphrenic abscess, 1 incomplete adhesiolysis, 1 port site hernia, 1 port-site seroma) complications.
CONCLUSION
Our preliminary data may justify further clinical study to clarify the role of laparoscopy in managing acute or subacute abdominal conditions.

Keyword

Laparoscopy; Acute abdomen

MeSH Terms

Abdomen, Acute*
Appendicitis
Child
Colon
Constriction, Pathologic
Corpus Luteum
Duodenal Ulcer
Female
Hernia
Humans
Intussusception
Laparoscopy*
Liver Abscess
Peritonitis
Peritonitis, Tuberculous
Pregnancy
Pregnancy, Ectopic
Prospective Studies
Rupture
Spleen
Subphrenic Abscess